Department of Internal Medicine, Saga Medical School, Saga, Japan.
J Gastroenterol Hepatol. 2013 Sep;28(9):1507-14. doi: 10.1111/jgh.12227.
The pathogenesis of non-alcoholic fatty liver disease (NAFLD) is now focusing on its organ cross-talk with not only adipose tissue but also systemic skeletal muscle. Cross-sectional and longitudinal studies were conducted to determine the role of intramuscular adipose tissue content (IMAC) measured by computed tomography on the severity of NAFLD/non-alcoholic steatohepatitis (NASH).
Two hundred eight Japanese patients with NAFLD/NASH diagnosed by liver biopsy were enrolled into a cross-sectional study. Twenty-one patients were enrolled in a longitudinal study and received a programmed diet and exercise intervention, in some cases the combination of pharmacotherapy. We measured IMAC in the multifidus muscle and biochemical parameters, and conducted liver histology to assess NAFLD/NASH status.
Histopathological stage in terms of simple steatosis and Brunt's classification was significantly correlated with IMAC (P < 0.01). Multivariate logistic regression analysis indicated that risk factors associated with the severity of NASH were IMAC and aging (IMAC: odds ratio = 2.444, P < 0.05; Age: odds ratio = 2.355, P < 0.05). The interventions improved histopathological changes in 11 patients with NASH as well as IMAC.
These results suggest that skeletal muscle fat accumulation may have been linked to the pathogenesis and severity of NASH.
非酒精性脂肪性肝病（NAFLD）的发病机制目前正聚焦于其与脂肪组织及全身骨骼肌的器官对话。通过横断面和纵向研究，确定计算机断层扫描（CT）测量的肌肉内脂肪组织含量（IMAC）在 NAFLD/非酒精性脂肪性肝炎（NASH）严重程度中的作用。
208 例经肝活检诊断为 NAFLD/NASH 的日本患者纳入了横断面研究。21 例患者纳入了纵向研究，并接受了饮食和运动计划干预，在某些情况下还接受了药物治疗联合干预。我们测量了多裂肌的 IMAC 和生化参数，并进行了肝脏组织学检查以评估 NAFLD/NASH 状态。
单纯性脂肪变性和 Brunt 分级的组织病理学分期与 IMAC 显著相关（P < 0.01）。多变量逻辑回归分析表明，与 NASH 严重程度相关的危险因素是 IMAC 和年龄（IMAC：比值比 = 2.444，P < 0.05；年龄：比值比 = 2.355，P < 0.05）。干预措施改善了 11 例 NASH 患者的组织病理学变化和 IMAC。
这些结果表明，骨骼肌脂肪堆积可能与 NASH 的发病机制和严重程度有关。
